“I had a major surgery last month. I received 15 stitches. The surgery was totally pain free! What a fine surgeon Dr Pinto is.” Who was your anaesthetist? Anaesthetist came to see me but I don’t remember her name! Usual isn’t it?
Both CNN and Forbes magazine lists anaesthetists as the best paying job in USA followed by surgery. However in many parts of the world it is not unusual that people do not remember the lesser mortals during surgery. Infact, many hardly consider them doctors. Let us see what it takes to become one.
Anaesthetists or anaesthesiologists known for healing pain of all kinds, are qualified medical doctors who take up anaesthesia as part of their postgraduate programme like other specialities such as surgery, gynaecology, ENT, ophthalmology, and so on. It takes minimum seven years of specialist studies after six years at medical school to become a fully trained anaesthetist.
Anaesthetists are omnipresent in the hospital. Be it the operation theatre known to many, but also in intensive care, on the wards, in the emergency department, and in the pain clinic.
Before any surgery, they assess people’s fitness for surgery, how likely they are to suffer complications, and support them throughout the operation and into the postoperative period. Hence they are rightly termed perioperative physicians. If there’s an emergency during an operation the team looks to the anaesthetist for leadership, as the surgeon is often too focused on fixing the surgical issue relying totally on the anaesthetists to safeguard the life of the patient.
Anaesthesiologists are experts in physiology, pharmacology, and physics; they have to know about everything from cellular respiration to how the drugs work, to the internal workings of a defibrillator, a machine used to bring a shocked heart back to life.
In the intensive care and emergency departments they are required for providing life saving measures including resuscitation. The skills acquired during their training are most required for these purposes and hence most of the Adult Intensive Care Units are managed by anaesthetists in many hospitals around the world. Even when other specialty doctor’s train to become intensivists (doctors working in ICU/Critical Care) they have to undergo compulsory anaesthesia training for at least six months to acquire those skills required for saving lives.
You are likely to come across anaesthetists in other areas too. Some procedures such as radiological imaging, scanning, endoscopy and dental treatment require the help of the anaesthetist to ensure that you are pain free and anxiety free and at times you may be given a general anaesthetic during these procedures.
Some anaesthetists choose to specialise in caring for specific sorts of pain including pain in childbirth and long-term pain problems termed as chronic pain. In this era of subspecialisation and with widening scope and requirement in various sections of the hospital, anaesthetists now specialise in a particular area of surgical practice such as neurosurgery, cardiac surgery, paediatric surgery, pain management or critical care to give focussed care. Most of the doctors have very little exposure and experience of anaesthesia during their training and therefore never consider it as a career choice.
With increasing awareness and rising global demand for anaesthetists more and more doctors are opting to choose anaesthesia for postgraduate training. In short, anaesthesia (and the exposure to Intensive Care) offers a unique opportunity to care for the ‘whole’ patient while managing them through their surgery, to facilitating the management of the sickest patients in the hospital (frequently when other medical colleagues in other specialties are no longer comfortable managing them). The responsibility is great, but so are the interactions with members of almost every hospital specialty, making it a fantastically ‘social’ career.
Dr Juhi Chandwani is a Consultant Anaesthetist and Intensivist at Royal Hospital.